WASHINGTON -- In Florida, the state's main nonprofit health organization is sending out flyers, running radio spots, and even calling people individually to remind them to sign up for health insurance. In Texas, volunteers are fanning out across the state. And in Utah, with the highest per capita number of children enrolled in Obamacare in the nation, officials are squeezing every penny of their diminished budget as they work to advertise the online marketplaces where people can purchase federally subsidized insurance policies.
Somehow it's working, at least for now. Initial reports from the agency supervising the program show Obamacare sign-ups for the federal marketplace are well ahead of the expected pace, at more than 600,000 in its first four days, leaving experts to wonder whether the volume is about successful advertising, a backlash from all the talk about scrapping Obamacare, officially known as the Affordable Care Act (ACA), or just an initial rush among the well-informed.
"I don't have numbers yet, but anecdotally, even in our rural areas we are hearing they are busier than they have ever been," said Jodi Ray, program director of Florida Covering Kids & Families, a nonprofit based at the Chiles Center at the University of South Florida.
The nonprofit's budget, nearly $5 million last year, was cut by $900,000 this year, Ray said. With fewer staff members and less money for advertising, Ray has pushed resources into the six-week sign-up period, and the rest of her budget this year will take a hit. She says there's lots of misinformation out there, but that the sign-ups reflect that "people actually need (health insurance). The need is there, and the demand is there."
But some advocates worry about the coming weeks. Marketing got a lot harder this fall among the 39 states that use HealthCare.gov, and for a very specific reason: President Donald Trump, in his effort to undermine his predecessor's signature legislative achievement, slashed the advertising budget by 90 percent and the open enrollment period from 12 weeks to six.
As a result, many states have been patching together public relations as they're able: stretching the limited federal funds, relying on volunteers, or filling gaps from their state treasuries. And they're fighting not only a lack of resources, but also persistent rumors, driven by the unsuccessful "repeal and replace" effort in Congress, that the Affordable Care Act is dead or dying.
Randal Serr, director of Take Care Utah, a network of public and private enrollment "navigators," said there are fewer navigators to assist with sign-ups because 61 percent of its funding was cut, bringing the total down to $290,000 from $740,000.
"Based on what we're seeing, there's a really high demand," Serr said. "But there's a lot of confusion generally on costs, whether 'repeal and replace' happened, or what the executive order means. Those things are really throwing people off."
Despite the misinformation, the facts are that the open enrollment period is Nov. 1 to Dec. 15 of this year in most states. In states that run their own marketplaces, and therefore don't get federal money for outreach, enrollment periods generally have been extended.
"Our tracking polls show a vast amount of confusion. People don't know when (open enrollment) begins or when it ends. We see about 30 percent of the public thinks ACA was repealed, or they are not sure," said Karen Pollitz, senior fellow at the Kaiser Family Foundation, which studies health care. "We see people in the majority of states who believe they won't be able to afford it at all."